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The Cost-effectiveness Of Primary Care For Indigenous Australians With Diabetes Living In Remote Northern Territory Communities

The cost-effectiveness of primary care for Indigenous Australians with diabetes living in remote Northern Territory communities

The cost-effectiveness of primary care for Indigenous Australians with diabetes living in remote Northern Territory communities

Summary
Objective: To evaluate the costs and health outcomes associated with primary care use by Indigenous people with diabetes in remote communities in the Northern Territory.
Design, setting and participants: A population-based retrospective cohort study from 1 January 2002 to 31 December 2011 among Indigenous NT residents ≥ 15 years of age with diabetes who attended one of five hospitals or 54 remote clinics in the NT.
Main outcome measures: Hospitalisations, potentially avoidable hospitalisations (PAH), mortality and years of life lost (YLL). Variables included disease stage (new, established or complicated cases) and primary care use (low, medium or high).
Results: 14 184 patients were eligible for inclusion in the study. Compared with the low primary care use group, the medium-use group (patients who used primary care 2–11 times annually) had lower rates of hospitalisation, lower PAH, lower death rates and fewer YLL. Among complicated cases, this group showed a significantly lower mean annual hospitalisation rate (1.2 v 6.7 per person [P < 0.001]) and PAH rate (0.72 v 3.64 per person [P < 0.001]). Death rate and YLL were also significantly lower (1.25 v 3.77 per 100 population [P < 0.001] and 0.29 v 1.14 per person-year [P < 0.001], respectively). The cost of preventing one hospitalisation for diabetes was $248 for those in the medium-use group and $739 for those in the high-use group. This compares to $2915, the average cost of one hospitalisation.
Conclusion: Improving access to primary care in remote communities for the management of diabetes results in net he Continue reading

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Diabetes programme ‘changing my life’

Diabetes programme ‘changing my life’

Amanda Paulos has struggled with type two diabetes for a decade.
But the 41-year-old said she was getting to grips with the chronic condition after joining a programme designed to reverse the disease.
The mother of four, from Smith’s, has lost weight, her average blood sugar readings have dropped and she was able to go off two of her medications.
Ms Paulos said: “In October, I had my HbA1c, which is a three-month average blood sugar reading, and I had that go down to 6.2 per cent.
“That is the lowest I’ve ever been at any time it’s ever been tested in my life and I cried tears of joy. That was down from 8.8 per cent in May.”
BDA diabetes educator Sara McKittrick explained that in someone who does not have diabetes the HbA1c should be under 6 per cent.
Ms Paulos, who also lost 14lbs, added: “I’ve gone from four medications down to two — that’s big news actually, very big news.”
She discovered she had gestational diabetes when she was pregnant with her second child, although she did not realise she had any symptoms.
Ms Paulos said: “I was tired, I was going to the bathroom a lot — these are just normal pregnancy things.”
It happened again when she was pregnant with her two youngest children.
She later went into a pre-diabetes phase and “sometime later type 2 diabetes”.
She said: “It’s quite a difficult thing to think about. I was very unhappy and I am sure many people will echo that.”
Ms Paulos visited dietitians and nutritionists with minimal success. Medications piled up until she was taking the maximums possible prescription.
A relativ Continue reading

Rising Diabetes Rates Are Costly for Employers

Rising Diabetes Rates Are Costly for Employers

Type 2 diabetes, characterized by high blood sugar and insulin resistance, and linked to unhealthy diets and a lack of regular exercise, is increasing among U.S. adults. That translates into high costs for employers—more than $20 billion annually due to unplanned, missed days of work.
The Cost of Diabetes in the U.S.: Economic and Well-Being Impact, a new report by Gallup researchers and Sharecare, a health and wellness engagement firm, was released to coincide with World Diabetes Day on Nov. 14.
November is also recognized by the Centers for Disease Control and Prevention, among others, as National Diabetes Month, a time for promoting awareness about managing diabetes.
(Click on graphic to view in a separate window.)
Being obese (severely overweight) is a leading risk factor for developing diabetes, the report noted. People with diabetes have much higher rates of other chronic disease such as high blood pressure, high cholesterol, heart attack and depression, and they are less likely to get regular exercise or engage in other healthy behaviors.
The findings are based on a subset of 354,473 telephone interviews with U.S. adults across all 50 states and the District of Columbia, conducted from January 2015 through December 2016 as part of the Gallup-Sharecare Well-Being Index. Diabetes cost analysis findings were drawn from research by the American Diabetes Association.
"While most clinicians agree that managing diabetes improves health and reduces medical costs, the benefit to employers also extends to a more productive workforce," said Sharecare Vice President Sheila Hol Continue reading

Diabetes as a Disease of Fat Toxicity

Diabetes as a Disease of Fat Toxicity

The reason people get results with low-carb high fat diet is because of the minimal effects on insulin fat provides. There is no 2 ways around it. The camp that is lying is the camp that promotes starchy and moderate to high carb as either a cure or a mean to prevent diabetes. It’s all completely just wrong.
Put it this way, you ever heard of the term “if it ain’t broke don’t fix it”? Well there is a reason the primary and go-to cure from nearly every doctor (including the mainstream western doctors) is low-carb & high fat.
The other issue is, there was a person here who wrote up a decent little spiel on how insulin and diabetes go hand in hand. It got tons of likes, and consequently the mods of this forum pulled it, because I guess it “didn’t agree” with their views. Therein lies the problem, they don’t want people to know the truth for some odd reason.
I’ll break it down in a nutshell:
Type 1 Diabetes: Insulin dependent. People are usually born with this or acquire it at a very young age. These people are usually paper thin. They need to take insulin so they can in fact store their nutrients, otherwise they starve and die.
Type 2 Diabetes: Insulin Resistant – People acquire this through bad diet and partly (possibly) pre-disposed to it at birth making them a little more likely to get it if they aren’t careful. Insulin resistant is at it sounds, the body (or cells in this case) are resistant to the insulin the body produces.
So the question is, why? Well when you think of insulin as some annoying dude who continually knocks at the door, and your ins Continue reading

Insulin, glucagon and somatostatin stores in the pancreas of subjects with type-2 diabetes and their lean and obese non-diabetic controls

Insulin, glucagon and somatostatin stores in the pancreas of subjects with type-2 diabetes and their lean and obese non-diabetic controls

In type-2 diabetes, both insufficient insulin and excessive glucagon secretion contribute to hyperglycemia. We compared insulin, glucagon and somatostatin stores in pancreas obtained at autopsy of 20 lean and 19 obese non-diabetic (ND), and 18 type-2 diabetic (T2D) subjects. From concentrations and pancreas weight, total content of hormones was calculated. Insulin content was 35% lower in T2D than ND subjects (7.4 versus 11.3 mg), whereas glucagon content was similar (0.76 versus 0.81 mg). The higher ratio of glucagon/insulin contents in T2D was thus explained by the decrease in insulin. With increasing BMI of ND subjects, insulin and glucagon contents respectively tended to increase and decrease, resulting in a lower glucagon/insulin ratio in obesity. With aging, insulin and glucagon contents did not significantly change in ND subjects but declined in T2D subjects, without association with the duration of diabetes or type of treatment. The somatostatin content was lower in T2D than ND subjects (0.027 versus 0.038 mg), but ratios somatostatin/insulin and somatostatin/glucagon were not different. In conclusion, insulin stores are about 1/3 lower in T2D than ND subjects, whereas glucagon stores are unchanged. Abnormal secretion of each hormone in type-2 diabetes cannot be attributed to major alterations in their pancreatic reserves.
Glucose homeostasis mainly relies on the opposite hypoglycemic and hyperglycemic properties of insulin and glucagon. In type-2 diabetic (T2D) subjects, hyperglycemia is largely the consequence of insufficient insulin secretion and excessive glucag Continue reading

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